New COVID vaccine rules could raise costs and cut access in the DMV

Driving the news: Health and Human Services Secretary Robert F. Kennedy Jr. announced a series of moves this week that will limit who is eligible for COVID vaccines as the stratus variant spreads across the country.

• The FDA rescinded general emergency use authorizations for Pfizer and Moderna mRNA shots, according to Kennedy.
• Boosters for high-risk patients were approved, though.
• And patients who want COVID vaccines will first have to consult with their doctor rather than booking directly with a pharmacy.

Zoom in: Adults 65 and older are eligible for an updated Pfizer-BioNTech COVID vaccine, as well as new shots from Moderna and Novavax.

• Anyone between 5 and 64 is eligible if they have at least one underlying health condition — including asthma, cancer, kidney disease, heart conditions, HIV, certain mental health conditions, physical inactivity and smoking
• For children: The new FDA policy doesn't approve the Pfizer vaccine for healthy children under age 5, leaving it open to a doctor's discretion to prescribe off-label shots. The Moderna vaccine has approval from the FDA for children 6 months old and up with underlying conditions.

Reality check: Many health experts argue that shots are still important for the general public, which remains at risk for severe outcomes as well as long COVID.

Zoom out: Individuals who aren't part of the recommended groups may not be covered by insurance and forced to pay out of pocket — a strain, especially for families on Medicaid, given a COVID shot can cost around $140.

• Medicaid covers over 285,000 DC residents, including 95,000 infants and children, per city officials.

What they're saying: DC Health officials tell Axios they're unclear on next steps. Their shots, allocated through the CDC's Vaccines for Children Program and another program serving uninsured adults, have yet to be recommended by a CDC panel.

• "There's been no communication about when that recommendation may occur from our federal partners," DC Health spokespeople tell Axios.

D.C. pediatrician Lanre Falusi told WAMU that there's a lot of uncertainty and anxiety among families.

• Some are booking shots to coincide with their kid's eligibility — the same week as their birthdays.

Behind the scenes: The CDC panel isn't slated to convene for another three weeks, according to the New York Times, and due to a wave of high-level shakeups at the agency, the chair of the Senate's health committee has asked for it to be "indefinitely" postponed.

• Pharmacies in a variety of jurisdictions are banned from administering vaccines that the panel doesn't recommend. CVS — the country's largest pharmacy chain — is not offering COVID vaccines in 16 states.
• CVS spokespeople tell Axios that the chain will offer, "based on the current regulatory environment," the latest FDA-authorized COVID vaccines in Maryland but not yet D.C. or Virginia. "States may change at any time."

Yes, but: CVS will offer the updated vaccines to D.C. and Virginia patients, "depending on their age, if they present an an authorized prescriber's prescription," spokespersons tell Axios.

By the numbers: The latest CDC data shows COVID rates in D.C., Virginia and Maryland are all low, though cases and related ER visits are increasing in the two states as well as across the country.

• Mortality rates are lower than the surges seen during the height of the pandemic.

What we're watching: The CDC is expected to weigh in soon with its recommendations, which can impact whether insurers will pay for vaccines or whether patients will need to pay out of pocket for them.

Go deeper on how broadly insurers may cover the shots.